| Brand Name | Rad-97 |
| Common Device Name | Monitor, Physiological, Patient (Without Arrhythmia Detection Or Alarms) |
| Manufacturer (Section D) |
| Masimo - 15750 Alton Pkwy |
| 15750 alton pkwy |
| irvine CA 92618 |
|
| Manufacturer (Section G) |
| Masimo - Mexicali |
| industrial vallera de mexicali calzada del oro, no.2001 |
|
| mexicali, baja california 21600 |
|
MX
21600
|
|
| Manufacturer Contact |
|
lusine
boyadzhyan
|
| 15750 alton pkwy |
| irvine, CA 92618
|
|
+1(949)297-7167
|
|
| MDR Report Key | 50393444 |
| Report Number | 3019388613-2026-00549 |
| Device Sequence Number | 9589024 |
| Product Code |
MWI
|
| UDI-Device Identifier | 00843997012317 |
| UDI-Public | (01)00843997012317(11)240827 |
| Combination Product (Y/N) | N |
| Initial Reporter State | TX |
| Initial Reporter Country | US |
| PMA/510(K) Number | K212161 |
| Number of Events Summarized | 1 |
| Summary Report (Y/N) | N |
| Reporter Type |
Manufacturer
|
| Report Source |
Health Professional,User Facility |
| Initial Reporter Occupation |
Non-Healthcare Professional
|
| Remedial Action |
Other |
| Type of Report
| Initial,Followup |
| Report Date (Section B) |
07/28/2026 |
| 1 Device was Involved in the Event |
|
| 1 Patient was Involved in the Event |
|
| Is this an Adverse Event Report? |
No
|
| Is this a Product Problem Report? |
Yes
|
| Operator of Device |
Health Professional
|
| Device Model Number | 9738 |
| Was Device Available for Evaluation? |
Yes
|
| Date Returned to Manufacturer | 08/03/2026 |
| Is the Reporter a Health Professional? |
No
|
| Was the Report Sent to FDA? |
No
|
| Type of Report(Section G) | Thirty-Day |
| Initial Date Received by Manufacturer | Not provided |
| Supplement Date Received by Manufacturer | 08/24/2026
|
| Initial Report FDA Received Date | 08/23/2026 |
| Supplement Report FDA Received Date | 09/16/2026
|
| Was Device Evaluated by Manufacturer? (Y/N) |
Yes
|
| Date Device Manufactured | 08/27/2024 |
| Is the Device Labeled for Single Use? (Y/N) |
No
|
Is This a Single-Use Device that was Reprocessed and Reused on a Patient? (Y/N) |
No
|
| Usage of Device |
Unknown
|
| Patient Sequence Number | 1 |
| Patient Sex | Unknown |
|
|